Virtual leaps for medicine A Rockville company, HT Medical Systems Inc., is developing virtual reality training systems that could dramatically alter how doctors perform some of the most complex surgical procedures.

December 27, 1998|By Mark Guidera | Mark Guidera,SUN STAFF

Laid back and soft-spoken, Greg Merrill doesn't seem the sort of fellow who'd turn a whole industry upside down.

But the 33-year-old Merrill, whose passions lean to racing Porsches and the latest electronic gadgets, is at the forefront of a revolution that could dramatically alter how medical students and doctors train and practice procedures ranging from a common catheterization to complex heart and brain surgery.

Indeed, experts say, the technology that Merrill's company, HT Medical Systems Inc. of Rockville, is developing -- virtual reality training systems -- has moved that revolution a step forward from the nascent state in which it's been locked for years.

Some of the hurdles HT's young team of computer scientists, engineers and computer graphics experts have been faced with overcoming: the sometimes disorienting limitations of virtual reality technology, computer microchip capabilities that are costly or don't measure up and the difficulty of replicating the way human tissue and organs feel and respond when prodded, poked and pierced.

In the VR world, that attribute is called "haptic response," and it's one of the Holy Grails of moving the technology forward to a point where medical schools, doctors and medical-device manufacturers fully embrace VR as a teaching, training and marketing tool, experts say.

Today, thanks to advancements in haptic technology and powerful new computer graphics programs that don't cost their weight in gold, HT Medical and a smattering of other companies are marketing a first generation of VR training systems.

By just about everyone's account, the technology and the industry are still in a genesis state. How big the market for these systems will be is a matter of debate among experts.

Some believe that it will soon blossom into a commercial niche that rings up sales eclipsing $100 million a year, and altering medicine in much the same way that robotics has changed manufacturing.

But others argue that the market isn't yet commercially viable, that it could be many years before the technology advances to a state where medicine views VR and robotic training devices as a complement to or replacement for the traditional mentor-assistant teaching method.

"This is really a new market that's just beginning to come into its own," said Steve Hosier, vice president for corporate finance at Miller Johnson & Kuehn Inc., a Minneapolis-based investment bank that raised money for HT last year in a private placement transaction.

"It's anybody's guess how big it will be," Hosier said. "But when you consider all of the potential applications for the technology and the global need, it's easily a couple-of-hundred-million-dollar market."

Dr. Gerald Higgins is vice president for the Center for Information-Enhanced Medicine (CieMed) Global Enterprises, a commercial joint venture between the Johns Hopkins University in Baltimore and the National University of Singapore, and a leading surgical simulation expert.

A difficult road ahead

He thinks the medical simulator industry has a difficult road ahead.

"I'm one of the biggest believers in this technology, but right now there's really only a small market for it," Higgins said.

The emerging industry, he said, faces difficult technological hurdles and the fact that no medical associations or boards have plans to require VR simulation training as a requirement for certification.

Also, Higgins said, for medicine to see advantages in simulation technology for training, a set of standards must be established to measure users' performance.

For now, the industry includes just a few privately owned companies.

These include HT Medical; Eagle Simulations/MedSim Inc. headquartered in Fort Lauderdale Fla.; and Boston Dynamics in Cambridge, Mass. Eagle markets a simulator for anesthesiology training. The $200,000 Patient Simulator device is based on a sensor-loaded mannequin that mimics heart and breathing sounds, and traumatic physiological events, such as hemorrhagic shock.

Merrill, a psycho-biology major who launched HT in 1987 right out of college with his brother Jonathan, then a medical student, is bullish on the promise of medical simulator technology that blends robotics, which provides the tactile sensations, and computer imaging, which replicates how the body's complex internal wiring and plumbing look.

"We think we can leverage this technology across a lot of different medical procedures," Merrill said.

Merrill and his team at HT have targeted three segments of the market for VR technology: training for medical professionals, practicing minimally invasive surgical procedures, and showing how new devices are to be properly used for marketing and training efforts.

The initial focus for the privately held company: develop simulators for endoscopic, endovascular, and intravenous procedures for these broad markets.

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